METRO MATTERS

METRO MATTERS; Breathing New Life Into a Hospital

By Sam Roberts

Published: December 28, 1992

WHEN the Koch administration announced the closing of Sydenham Hospital in 1979, Harlem rallied behind the venerable institution as a symbol of community pride, but not necessarily of quality health care. Finally, Harlem has both.

The same year that the Sydenham decision was announced, a small group of civic-minded New Yorkers reorganized North General Hospital. They enlisted public officials, philanthropists and major medical institutions to extricate the foundering hospital from unpaid bills and to raise both money and standards.

The struggle to resuscitate North General is more than a medical miracle. It was a team effort that harnessed the influence of powerful people: among them, Charles B. Rangel, the local Congressman; Basil A. Paterson, the hospital's lawyer and advocate in Albany; former state Health Commissioner David Axelrod, and Randolph Guggenheimer, the lawyer and philanthropist who recently received the United Hospital Fund's Distinguished Community Service Award for faithfully championing North General, first, almost single-handedly, as its only trustee and then as chairman of the nonprofit community hospital.

But North General's very survival as a symbol of self-reliance, the hospital's stunning new home across Madison Avenue from Marcus Garvey Park, and its emergence as the nucleus of a critical mass in the revival of Harlem are largely a testament to the perseverance of one person. In this season of hope, his commitment, and success is another reminder that one person can make a difference.

Add the name of Eugene I. McCabe, North General's president, to an honor roll of largely unsung heroes, including Patrick Daly, the martyred principal in Red Hook; Richard Green, who heads the Crown Heights Youth Collective; Clara Hale, who nurtured Harlem's neediest babies and Ned O'Gorman, who strives mightily to shepherd them through adolescence; Helen VerDuin Palit, who founded City Harvest, which feeds the hungry; Anna Lou DeHavenon, an urban anthropologist whose painstaking investigations have verified the degree of poverty in the city and have also helped mitigate it, and Theodore Gross, a playwright who not only conceived a contribution to society that is remarkable in its simplicity but actually carried it out -- generating hundreds of thousands of dollars for services for the poor, the hungry and the homeless by harvesting people's unwanted pennies. (His Common Cents, at 212-PENNIES, is searching for benefactors to cover overhead).

As for Mr. McCabe, he modestly attributes his success and endurance to naivete. "If you don't know how difficult something is, you just keep going," said the 55-year-old technocrat with a heart. "Syndenham was a card and needed to be played. The issue of quality of care at Sydenham was understood by everyone. But even the things that don't work so well are part of the community's fabric. It wasn't only a loss of services, but it's a feeling that they don't think Harlem's so important."

Mr. McCabe, who attended President-elect Bill Clinton's economic summit earlier this month, said the task at hand was to balance and manage competing needs. "Everyone wants universal access, improved quality and at a lower cost," he said. "The health commissioner says you can have two of the three. The Government will probably put a cap on Federal spending for health care and that will have a ripple effect. The nation needs more managed, primary and preventive health care, which are all the things were trying to do.

"Our feeling was that if you could do basic primary care well you would make an impact. We don't want to do open-heart surgery or brain surgery. Someone coming here understands they're going to get basic, primary care of quality. We want to be a well-managed community hospital."

Mr. McCabe is also a believer in decision making at the local level. "At a teaching hospital, sometimes standards and patient-care expectations are in conflict. And in the municipal hospitals, policy-making is diffused and sometimes decisions can't get made. I don't feel they can ever run as efficiently as they need to without the ability to make them free-standing with responsibilities for budget and admission. They should all be spun off. But if our hospital were twice the size, like some municipals, it wouldn't have worked. It's got to be small enough to have this personal involvement."

With 240 beds and 2,200 employees, North General is Harlem's largest private employer. Mr. McCabe seems to know virtually every employee by name.

North General is also emerging as a pivotal player in Harlem's revival. A medical and office annex to the hospital will be completed next spring. The hospital is sponsoring several affordable-housing projects nearby in conjunction with the city and the state and also a residence for homeless people with AIDS.

"We're not in the housing business," Mr. McCabe said, "but our feeling is if you build up the community you strengthen the hospital."

From the cherrywood lobby to the emergency room, which gets 30,000 visits a year, North General's new building, which opened a year ago this month, is an immaculate monument to what is doable against all odds.

"The new building gives people the idea that things can get better and sense of accomplishment builds on itself," Mr. McCabe said. "If our goal is to deliver first-rate primary care, now that we've had some success people think it's possible."